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Indigenous Concepts of Health and Healing in Andean Populations

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Indigenous Concepts of Health and Healing in Andean Populations INDIGENOUS CONCEPTS OF HEALTH AND HEALING IN ANDEAN POPULATIONS. The Relevance of Traditional MEDICINE in a Changing World Elizabeth Currie Report to the European Commission Horizon 2020 October 2019 This report is dedicated to Juana Icha and her guardian spirit Apu Parato, whose poignant story forms a recurrent theme through this work. It is also dedicated to the wonderful Indigenous people of the communities of Salasaka, Zuleta and Ugsha, highland Ecuador, who helped to make this study possible. Causa contra Juana Icha, 1650 ii ACKNOWLEDGEMENTS This study would not have been possible without funding provided by the European Commission via the Horizon 2020 initiative, Marie Sklodowska Curie Global Fellowship Awards, so my thanks go first and foremost to them for making this work possible at all. I hope that I have been able to do justice to the generosity of this funding in the study outcomes presented in this report. The University of York, Department of Archaeology provided the academic and working context for the study in the UK and in Ecuador, the Universidad San Francisco de Quito (USFQ), was ‘host’ to the two ‘outgoing’ years of my secondment within Ecuador, so I sincerely thank both for this. Professor John Schofield, the project PI, gave me the original idea for this project, firstly in terms of the topic matter of ‘traditional medicine’, and then what proved to be the most innovative idea, how to make a study of this relevant to the present day population displacement and refugee crises. Professor Hugh MacPherson of the Department of Health Sciences, University of York also provided key early insights and encouragements which helped me develop what later proved to be an award winning proposal. Part of this project was also hosted by the Department of Health Sciences, and Professor Patrick Doherty always offered his unfailing support and encouragement at different stages of the work, especially in the third phase of the project involving the development of transferable models. Dr Alex Harrison, also of the Department of Health Sciences, generously gave his time and supported me through the quantitative analysis of the survey results, offering critical advice with SPSS and I am very indebted to him for this. In the Department of Archaeology, special thanks go to Vicky Moore and Jo Tozer in departmental administration; I realise that I haven’t always been the easiest member of staff to ‘manage’ at times and I thank them for their patience and support. Also Neil Gevaux in IT, whose last minute help has so significantly eased the final production of this report. iii In Ecuador, I owe many thanks to Dr Diego Quiroga, my project supervisor in USFQ, for his inspiring insights and the different important connections he was able to benefit the project with. Dr Fernando Ortega Pérez of the School of Public Health, USFQ and specialist in Andean traditional medicine, provided key advice and practical help in the first stage of the project and with the development of the survey instrument, so I would like to acknowledge and thank him for this. William Waters, also of USFQ School of Public Health, is thanked for his own helpful support at different stages of my work. I would also like to thank Javier Rodriguez, consultant in gastro-enterology, for his important insights and information about the Ecuadorean health system and its interface with Indigenous medicine. Moving to the survey and fieldwork stages of the work, there is no way I can do real justice to how much I benefited from the different Indigenous communities who participated in this study and the actual survey respondents, for their willingness to contribute their time and their views. I can genuinely say that my experiences with them were amongst the most enjoyable and rewarding and I learned an immense amount from them. I would particularly like to thank Jorge Caisabanda Caizabanda, Indigenous Salasaka, for his help throughout the study and for the critical insights with his community he was able to provide. Don Rubelio Masaquiza Jeréz, yachak of the Salasaka community, himself provided important study information and insights respecting traditional shamanistic healing practices and I would like to acknowledge and thank him for this. My two interview assistants Andrés Torivio Masaquiza of Salasaka and Cesár Caucango of Zuleta provided critical support and interface with their separate communities during the interview stage of the study. In Zuleta, several members of the Comunidad de Zuleta are owed thanks for their help, specifically Amable Cháchalo for his insights into the regional belief systems. Moving on to the Hacienda itself, I owe more to Fernando Polanco Plaza, general manager, for his friendship and unfailing interest in and support of my work than I can ever really do full justice to. I was able to stay many times at Hacienda Zuleta and was unfailingly treated as a friend and free to enjoy the amazing facilities that this beautiful place offers, now to the international tourist market. Fernando, his family and other people working in the administration there were always supportive of and interested in my work. The Hacienda is staffed almost exclusively by members of the Indigenous community of Zuleta and I counted iv as friends many of the people who worked there, who always seemed happy to see me and helped to make my stay there welcome. More recently, I would like to thank Olga Leralta, Ainhoa Ruiz Azarola and Ainhoa Rodriguez Garcia de Cortázar of the Andalusian School of Public Health at Granada, for their interest in this work and their preparedness to become involved, busy as they are, with the application of the study findings to their own work developing training modules for health care workers supporting the many refugees and asylum seekers arriving in southern Spain. Special thanks also go to Professor Renos Papadopoulos of the University of Essex, for giving me access to his own work and thinking in the development of innovative psychotherapeutic approaches to the counselling of refugees. Last, but far from least, very special thanks go to my daughter Jessica Steel, whose own extensive corpus of research into storytelling, mythos and the work of C.G. Jung has provided some of the most critical developmental thinking of this study. Our many conversations revolving around these subjects has benefited my own understanding immensely. v CONTENTS Acknowledgements iii Map of Study Region viii SECTION ONE: PROEJCT STAGE ONE. REGIONAL AND STUDY INFORMATION CHAPTERS 1. Methodology and development of the Health Beliefs Questionnaire 1 2. Ecuador: The Study Region and People Today. Survey Methodology 10 3. Healing Cosmology and Traditions in the Northern Andes 35 SECTION TWO: PROJECT STAGE TWO. THE SURVEY OF COMMUNITIES Survey Section 1. Concepts of identity in Kichwa Communities 61 Survey Section 2. Beliefs About the World and Nature 75 Survey Section 3. Life and the Human Body 93 Survey Section 4. Concepts of Health and illness 106 Survey Section 5. Traditional versus Modern Therapies 127 Survey Sections 6, 7 & 8. Traditional Healers 139 Survey Section 9. Health and Life Beliefs of Younger People 154 Survey Communities Population Analysis by Alex Harrison 157 SECTION THREE: PROJECT STAGE THREE. TOWARDS POLICY AND PRACTICE GUIDANCE: DISCUSSION OF THE EVIDENCE AND CONSTRUCTION OF MODELS Chapter 1. Indigenous Identity and Historical Consciousness 163 Chapter 2. Evolution of Indigenous Identity and ‘Empowerment’ in Ecuador 179 Chapter 3. Building the Bridge. A Discussion of the Evidence 189 Chapter 4. Modelling Health Beliefs in Traditional Populations 211 vi Culturally Integrative Models of Care Provision. The Study Region 226 Chapter 5. The Tale of Juana Icha: A Trial by Three Models. The Psychological Impact of Evangelisation 232 Chapter 6. From Bridge to Policy and Practice Guidance 252 Chapter 7. Heritage Discourses. What Constitutes ‘Heritage’ Now? 274 Chapter 8. Project Summary and Conclusions 286 Literature and Sources Cited and Consulted 292 ILLUSTRATIONS 319 APPENDICES 1. Christianisation of Salasaka Myths and ‘Near Death Experiences’ 328 2. Survey Instrument in English and Spanish 330 3. Qualitative Survey Tabulated Findings 340 4. Tabulated Survey Findings: Healers, Yachaks and Parteras 381 vii Map of Ecuador with Study Sites viii SECTION ONE: PROJECT STAGE 0NE. REGIONAL AND STUDY INFORMATION CHAPTER ONE Methodology and Development of the Health Beliefs Questionnaire Background to the study How people manage change is central to archaeological enquiry, with a timeless relevance into the contemporary human experience. Cultural belief systems and related rituals sustain a people’s sense of place and identity. The project ‘MEDICINE ‘ puts itself at the heart of this dynamic, using a time depth perspective to build conceptual models of indigenous understandings of health, disease and healing, and how these adapted and survived in the face of dislocation and persecution into present day forms, and the relationship and relevance these have to ‘modern’ biomedical systems of health. At the heart of the proposed action is understanding the critical place that notions of health and disease have in people’s conceptual understanding of the world they live in. When this world is impacted by adversity: the trauma of war, invasion, persecution and the imposition of alien systems of belief, modes of behaviour and epistemologies, there is a need to develop mechanisms that preserve the core belief system. This at the same time as engaging with the change processes that allow those core beliefs to evolve and survive, thereby maintaining, at heart, the critical sense of personal and collective identity. The research proposes to develop new conceptual frameworks that model this process, to expand our understanding of how people survive and adapt in response to cultural trauma. Current practices of Traditional Medicine (TM) have evolved within historical contexts into new forms which can tell us about the nature of pre-Columbian and historical indigenous belief systems and demonstrate how these beliefs and associated rituals and practices have 1 adapted and survived in social climates of persecution and repression.
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